Pediatric Emergencies: Imaging of Pediatric Head Trauma

William T.O’Brien, Sr., DO; Marguerite M.Caré, MD; James L.Leach, MD

Pediatric head trauma is an important cause of morbidity and mortality in children and may be seen in the setting of accidental or abusive injuries. Although many of the patterns of head injury are similar to adults, the imaging manifestations of head injury in children are more complex due to the developing brain and calvarium. Additionally, there are unique considerations for mechanisms of injury in children, to include abusive head trauma and birth-related injuries. The primary role of the radiologist is to identify and characterize the type and severity of head injury to help guide appropriate patient management.

Introduction
Pediatric head injuries are exceedingly common and may be seen in both the emergency and outpatient clinical settings. Regarding accidental injuries, motor vehicle accidents involve all age groups but occur more frequently in older children and adolescents. In younger children, falls are more prevalent, whereas bicycle and sports-related injuries are more common in older children. Although many of the patterns of head injury are similar to adults, the imaging manifestations of head injury in children are more complex due to the developing brain and calvarium. Additionally, abusive head trauma and birth-related injuries are unique mechanisms of injury to be considered in the pediatric population. The primary role of the radiologist is to identify and characterize the type and severity of head injury to help guide appropriate patient management. This review article discusses important imaging findings and patterns of pediatric head injury with a focus on how head trauma in children differs from that seen in adults (Table). Topics covered include calvarial fractures, extra-axial hemorrhage, cortical contusions, diffuse axonal injury, abusive head trauma, and birth-related injuries. [Read More]

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